2019 Volume 33 Issue 5 Pages 884-891
A 90-year-old man with acute cholecystitis underwent emergent laparotomy cholecystectomy. However, liver dysfunction prolonged after surgery, and contrast-enhanced CT was performed.
According to the CT findings, common bile duct injury was suspected, and the patient was transferred to our hospital for treatment.
Cholangiography with PTBD revealed complete dissection of the biliary injury, and a PTBD tube was indwelled from the left hepatic duct to the right hepatic duct.
After improvement in ADL, the patient was scheduled to undergo biliary reconstruction but no improvement was noted in the level that could be tolerated.
Moreover, because internalization was required, EUS-BD was performed via the PTBD route, and an internal and external catheters were placed in the stomach from the intrahepatic bile duct, and replaced with metal stents later.
In conclusion, EUS-BD via the PTBD route after PTBD is useful as a drainage method.
